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. 2022 Dec 2;30(spe2):e251579.
doi: 10.1590/1413-785220223002e251579. eCollection 2022.

COSTS ANALYSIS OF SPINAL COLUMN METASTASES SURGICAL TREATMENT

Priscila Barile Marchi Candido  1 , Fernanda Maris Peria  2 , Altacílio Aparecido Nunes  3 , Rômulo Pedroza Pinheiro  3 , Herton Rodrigo Tavares Costa  3 , Helton L A Defino  3
Affiliations

COSTS ANALYSIS OF SPINAL COLUMN METASTASES SURGICAL TREATMENT

Priscila Barile Marchi Candido et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Introduction: End-of-life cancer treatment is associated with substantial healthcare costs.

Objective: This study aimed to analyze the surgical treatment cost of spinal metastasis and epidural compression patients undergoing surgical treatment.

Methods: A retrospective cost analysis of 81 patients with spinal metastasis and epidural compression undergoing surgical treatment. Cost evaluation was defined in the following categories: medications, laboratory and imaging tests, nursery, recovery room, intensive care unit, surgical procedure, and consigned material. The cost of pain improvement, functional activity, and survival was also evaluated.

Results: The total cost of surgical treatment for 81 patients was $3,604,334.26, and the average value for each patient was $44,497.95. The highest costs were related to implants (41.1%), followed by hospitalization (27.3%) and surgical procedure (19.7%).

Conclusion: The cost of surgical treatment for spinal metastases is one of the most expensive bone complications in cancer patients. The cost of treatment related to outcomes showed differences according to the outcome analyzed. Hospital stay, tests, drugs, and intensive care play an important role in some of the costs related to the specific outcome. Level of Evidence II, Retrospective Study .

Introdução: O tratamento do câncer em fim de vida está associado a custos substanciais em saúde.

Objetivo: O objetivo do estudo foi analisar o custo do tratamento cirúrgico de pacientes com metástase espinhal e compressão peridural submetidos ao tratamento cirúrgico.

Métodos: Uma análise retrospectiva de custos de 81 pacientes com metástase espinhal e compressão peridural submetidos a tratamento cirúrgico. A avaliação de custos foi definida nas seguintes categorias: medicamentos, exames laboratoriais e de imagem, enfermaria, sala de recuperação, unidade de terapia intensiva, procedimento cirúrgico e material consignado. O custo relacionado à melhora da dor, atividade funcional e sobrevida também foi avaliado.

Resultados: O custo total do tratamento cirúrgico de 81 pacientes foi de R $ 3.604.334,26 e o valor médio de cada paciente foi de R $ 44.497,95. Os maiores gastos foram relacionados com implantes (41,1%), seguidos de internação (27,3%) e procedimento cirúrgico (19,7%).

Conclusão: O custo do tratamento cirúrgico para metástases espinhais é um dos mais caros entre as complicações ósseas em pacientes com câncer. O custo do tratamento relacionado aos desfechos apresentou diferença de acordo com o desfecho analisado e a permanência hospitalar, exames, medicamentos e terapia intensiva tem papel importante em alguns dos custos relacionados ao desfecho específico. Nível de Evidência II, Estudo retrospectivo .

Keywords: Costs and Cost Analysis; Hospital Costs; Palliative care; Spinal Cord Compression.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Karnofsky Performance Scale.
Figure 2
Figure 2. Frankel Classification of Spinal Cord Injury.
Figure 3
Figure 3. Sensitivity analysis showed a large range between the minimum and maximum.
See this image and copyright information in PMC

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